Provider Demographics
NPI:1316068174
Name:ARLINGTON ASSOCIATION OF NEUROLOGICAL SURGEONS, PA
Entity type:Organization
Organization Name:ARLINGTON ASSOCIATION OF NEUROLOGICAL SURGEONS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:W
Authorized Official - Last Name:HEITKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-274-4593
Mailing Address - Street 1:PO BOX 152679
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-8679
Mailing Address - Country:US
Mailing Address - Phone:817-274-4593
Mailing Address - Fax:817-274-4098
Practice Address - Street 1:811 W INTERSTATE 20 UNIT G10
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-5871
Practice Address - Country:US
Practice Address - Phone:817-274-4593
Practice Address - Fax:817-274-4098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80A470OtherBCBS OF TX
TX314595OtherCIGNA
TX00FM69OtherMEDICARE
TX0610290OtherAETNA
TX80A470OtherBCBS OF TX